New York State Hospital Data Exposes Big Markups, and Odd Bargains

Just how expensive is your hospital? In New York, the answer may lie in a trove of hospital cost data newly posted online by the State Health Department.

As part of an effort to make health care pricing more transparent, the state is naming hospitals and listing their median charges and costs for 1,400 conditions and procedures from 2009 to 2011. In 2011, prices ranged from the $8 bill at Benedictine Hospital in Kingston, N.Y., for treating a case of gastritis (cost: $2), to a $2.8 million charge for a blood disorder case at University Hospital of Brooklyn that cost it $918,462.

Hospital trade groups, who opposed the release of the database, say the figures will only confuse consumers, who rarely pay the sticker price for hospital care, especially if they have insurance. The hospitals also argue that cost figures, though based on reports to the government by the hospitals themselves, cannot be reliably compared because the state did not edit them for deaths, transfers and aberrations.

But even a quick search through the database for common procedures with the same diagnosis code and level of severity turns up a wild mix of startling bargains and enormous markups. For knee joint replacement surgery with moderate severity, for example, the Costco of medical care seems to be A. O. Fox Hospital in Oneonta, where the median charge for 22 cases was $1,376, and the median cost to the hospital was $1,057.

The next lowest price — $12, 661 — was charged by Kings County Hospital Center in Brooklyn, where 21 cases coded the same way cost the hospital only a little less — $12,476. In contrast, the median cost of the same operation was reported as only $11,180 at Vassar Brothers Medical Center in Poughkeepsie, but it charged four times more: a median of $51,897 for its 12 cases in 2011.

While insurance companies negotiate fees with hospitals that are lower than the billed charges, uninsured patients are often stuck with the full price and can be pursued by bill collectors.

Sylvia Murphy, a spokeswoman for Vassar Brothers, which is part of Health Quest, disputed the relevance of the charges listed by the state.

“The median charge is never what we charge our patients,” she said. “It’s more like a management tool. It’s just a number we have in our system.” The release of the data has caused concern, she added, “because it’s very confusing and it doesn’t show the full picture.”

For patients without insurance, she said: “The charge would depend on your financial situation. Every case is different.”

The most expensive place for the same knee surgery in 2011 was NYU Langone Medical Center in Manhattan. There, 20 cases coded the same way cost the hospital a median of $33,280 and were charged at $110,915.

Lisa Greiner, a spokeswoman for NYU Langone, responded in an email: “Hospital pricing is complicated and based on a set of comprehensive algorithms. Charges take into account volume, teaching hospital status, geographic region, quality of care and the fact that many medical procedures are reimbursed by government programs below costs.”

Bill Schwarz, a spokesman for the New York State Health Department, did not respond Monday when asked about such criticism.

The decision by the Cuomo administration to release the data comes during a series of articles in The New York Times documenting the opaque and arbitrary pricing of health care nationwide and a pattern of overcharging. In theory, more transparency could help consumers shop around for more reasonable care.

Among the most common hospital admissions each year are cases of childbirth and the routine medical care of healthy newborns. There, too, the database shows extreme and unpredictable variations in cost, markups and charges. A. O. Fox again seems like a bargain, the rare hospital that charged less, on average, for its 140 vaginal deliveries with minor severity than its reported median cost — $1,998 versus $2,603. Its administrators did not respond Monday to messages asking how it held down costs and prices.

At Westchester Medical Center in Valhalla, on the other hand, 183 deliveries coded the same way cost $6,692 and were charged at $22,413, among the most expensive such cases in the state.

David Billig, a spokesman for Westchester Medical, said the comparison was unfair. “As the region’s only tertiary and quaternary care center, Westchester Medical Center cares for the region’s sickest and most critically ill patients,” he said in an email. “For instance, we do only high-risk births.”

That left other puzzles unresolved, like why Maimonides Medical Center in Brooklyn spent $1,675 per case of newborn care and charged $5,400, while at Montefiore Medical Center in the Bronx, the cost was $2,586 and the price $10,950.

Melissa Mansfield, a spokeswoman for the Healthcare Association of New York State, a hospital trade group, said it supported efforts to provide consumers with information that could help them make informed choices. “The information that was released causes confusion,” she said. “Developing useful information will require a cooperative effort by all stakeholders.”

Correction:

A chart on Dec. 10 comparing New York hospital charges for a routine neonatal case in 2011, which accompanied an article about the variations in pricing, referred incompletely to one hospital, Good Samaritan. The chart included charges for the Good Samaritan hospital in Islip, not the one in Suffern.

A version of this article appears in print on , on Page A22 of the New York edition with the headline: State Hospital Cost Data Exposes Big Markups, and Odd Bargains. Order Reprints | Today’s Paper | Subscribe